STEP 1: Contact Us
Contact our office by calling 435-688-8582 to give us your personal information and to schedule an appointment or to ask any specific question that you don’t see covered below. Alternatively, you can contact us by e-mail at Ctrhealthco@gmail.com
STEP 2: Obtain the Comprehensive Blood Test Panel
We highly recommened you get a blood test panel before your visit. We will send you or the laboratory a requisition for testing.
Our preferred lab is LabCorp because of the nation wide availability and their unmatched economical pricing. We are certainly happy to work with any lab, it is the results that are important to us. You may find the location of the nearest LabCorp here. No appointment is necessary for your lab test. You must be fasting for 8 hours before the test is performed - nothing to eat or drink except water. Most labs open before 8AM. The results will be sent to our office 5 to 7 days later. We can accept certain lab tests that you may have already obtained within 3 months of your initial consultation. We will explain the pricing and the details of the laboratory panel at the time of your initial contact with our office.
STEP 3: Complete and Return the Consent Form and Questionnaire
After you have scheduled your appointment, you will be e-mailed or faxed a questionnaire on your health history as well as a “Consent for Hormone Treatment” form. The questionnaire and the consent form must be completed and returned to us prior to your appointment. Dr. Wilcox will review your completed questionnaire in advance so that your initial consultation will be as productive as possible.
STEP 4: Initial Consultation
The final lab results must be available before your visit. Dr. Wilcox will spend at least 30 minutes reviewing your questionnaire and lab test results prior to your visit and up to 1 hour at your appointment assessing your symptoms, verifying your medical history, conducting an examination, discussing your unique medical problems, answering your questions, jointly reviewing your lab results and then developing your unique treatment plan.
STEP 5: Treatment
At the end of your initial consultation, you and Dr. Wilcox will determine the course of your treatment. Prescriptions will be sent to the pharmacy which is best for you. If you are using a local pharmacy, you can usually pick up your prescriptions in 24 to 48 hours. Sometimes an out-of-town pharmacy may be used who will ship your prescriptions to you.
STEP 6: Follow-Up
After 2 weeks of treatment, we ask our patients to e-mail or call us with an update. After 8 to 10 weeks you will have your first follow-up consultation with Dr. Wilcox. You will usually but not always need to get a limited follow-up blood test 7 days before your consultation. Dr. Wilcox will discuss the effects of the program and adjust your dosages accordingly. You will repeat this process after another 6 months and again every year thereafter, depending on the situation.
The fee for the 60 to 90 minute initial consultation is $399. Follow-up consultations (usually 30 minutes) cost up to $149, often less, and new patients will need 1 or 2 follow-ups during the first year of treatment while the proper dosages are determined. Medications will be shipped to your door once you have re-ordered the medications you require or can be picked up at a local pharmacy depending on the prescription. Depending on your unique treatment plan, the cost of the prescriptions (without pharmacy benefits) ranges from $35 to $95 per month. The initial full panel of laboratory tests costs approximately $600.
Our office does not accept insurance for payment. However, this does not rule out the possibility of reimbursement by your insurance provider. We will be glad to provide you with properly coded invoices (superbills) that you may submit to your insurance company for reimbursement. Some insurance plans may cover the cost of office visits, according to their out-of-network provider schedule. You may be subject to an annual deductible and a co-pay, depending on your coverage. Please contact your provider for more details on coverage.
Will my insurance cover the cost of prescriptions?
Your hormone prescriptions, while always bio-identical, often include a mixture of both drug company products and compounded (pharmacy made) products depending on your unique medical needs. While most insurance companies that offer pharmacy benefits cover the cost of drug company products, only some insurance plans will cover compounded medications. If you wish to determine coverage in advance, tell your insurance provider that you may be treated with compounded medications containing bioidentical hormones.
Will my insurance cover the cost of laboratory tests?
We request that you pay us in advance for the laboratory tests that we order. Our office is then billed directly by the laboratory and our patients do not get a bill from the lab. Doing it this way has allowed us to negotiate very deep discounts on the pricing of the laboratory tests. Currently, our laboratory providers are LabCorp, Intermountain Health Care and Quest Diagnostics. Insurance plans will often cover most of the cost of laboratory tests. We will provide you with a coded invoice for the laboratory tests that can be submitted to your insurance provider. Speak with your insurance carrier for more details. The list of tests we perform can be obtained directly from us.
Many employers offer a Flexible Spending Account (FSA) to their employees. These arrangements permit the employee to stow a portion of their pre-tax earnings in a special account for use on health-related expenses NOT covered by primary health insurance. Depending on the type of FSA, these arrangements may cover the portion of your treatment not covered by your primary health insurance, including medications, office visits, co-pays, program fees, vitamins & supplements. Ask your employer or visit the IRS FSA site.
Hormones are self-administered once or twice per day via transdermal creams or patches (estrogen, progesterone, testosterone), oral capsules (progesterone, DHEA, pregnenolone, melatonin), sub-lingual tablets (melatonin, progesterone) or subcutaneous injections (HGH, HCG). Injections are relatively painless, using ultra-fine needles.
The bioidentical estradiol, progesterone and testosterone hormones we prescribe are derived from the wild Mexican yam or soy. These molecules are then modified to exact replicas of the hormones currently in your body. HCG hormone is human-derived, and HGH is produced using recombinant DNA technology. In every case, they fit the receptors in exactly the same way as the hormones in your body today.
Side-effects are often minimal and manageable when restoring hormones to youthful levels. Some patients report breast tenderness or swollen joints when first starting bioidentical hormone replacement therapy; these and other adverse reactions can be remedied by reducing the dosage. None of our patients have reported long-term side effects.
We do occasionally test cortisol levels when your history, exam and lab testing suggests that you may have an adrenal problem. We often use saliva testing for Cortisol as this allows several samples to be obtained throughout the day.
Whereas saliva testing may be accurate for hormones that circulate in high concentrations, such as progesterone, not all hormones can be accurately assessed using saliva. For instance, estradiol is typically present in picograms (trillionths of a gram!) Since we require extensive blood testing for each consultation, there is no need to collect saliva samples as well. All the hormones we assess can be accurately measured using the blood samples that will be collected already.
Bioidentical hormone replacement is perfectly safe after a hysterectomy. In fact, since the ovaries produce much of the testosterone in the female body, replacing this hormone is even more important.
You should continue treatment as long as you wish to see results or resolution of symptoms. Patients sometimes request to stop the treatment. If they ever consider restarting, we can assess their relative health by taking new measurements to determine if they would benefit from additional treatment. The vast majority of the more than 500 patients we have treated are continuing their treatment.
What happens if I stop? Will my body stop producing hormones on its own? Will my hormone levels decrease? Will I lose my gains?
In general, supplementation by exogenous (external) hormones will result in decreased endogenous (internal) production. However, the body tends to restore hormones to pre-treatment levels after cessation of treatment. If your own hormone production was low before treatment, it will most likely return to the same levels after treatment. As a result, most of the physical changes enabled by the program will gradually revert back to "normal".
Will my testes shrink on testosterone replacement therapy?
We currently restore testosterone using injections or transdermal testosterone cream, and HCG, human chorionic gonadotropin. Using the cream and injections, the testes will likely slow production of testosterone in response to (perceived) high levels. This condition also may result in minor atrophy or shrinking of the testes. HCG emulates luteinizing hormone, which stimulates the testes to produce their own testosterone, thereby preserving their function and size. This product is injected each 2 to 3 times per week by the patient using an insulin syringe. HCG can be prescribed in lieu of or in addition to the testosterone injections or transdermal testosterone cream.
The answer to the question of whether to cycle or not to cycle when undergoing bioidentical HRT (BHRT) is complex and depends upon many factors specific to each woman. It also entails a long discussion of the evidence for and against it at this time. Briefly, our current interpretation of available data is that while cycling may turn out to have benefits, there is not enough clinical trial data to mandate it for all patients, particularly those with a low risk of breast cancer and who have difficulty tolerating the fluctuation of hormones that cycling entails.
When should I start thinking about bioidentical hormones? My doctor wants me to wait until I reach menopause.
The menopause is defined as beginning on a single day--12 months after your last period. Your physician's suggestion that you wait until you have passed this milestone reflects an antiquated view of a woman's transition from the premenopause to menopause. The majority of women experience their most severe symptoms in the months to years leading up to this milestone. To wait for this single day would be to subject women to a year or more of unnecessary hot flashes, night sweats, mental fogginess, and bone loss. Our approach is to start addressing these symptoms as soon as they appear. They often begin several years before the final menstrual period, a time called the perimenopause. By so doing, we can avoid all the havoc that fluctuating hormone levels can wreak on a woman. Our approach is to smooth the transition from normal cycling through the menopause rather than to wait for a somewhat arbitrarily defined date.
I read Dr. Navar’s article about testosterone in Life Extensions Magazine. I’m interested in becoming a patient, but I don’t live anywhere near the Southern Utah area. What do I do?
We always prefers to see our patients in person, but under certain circumstances, the doctor will agree to do telephone consultations. Because testosterone can only be obtained by prescription and is a DEA schedule 3 controlled substance, the FDA and DEA frowns upon the practice of prescribing testosterone to patients without a doctor performing a physical examination. On the other hand, with the price of fuel so high, travel costs and the costs of time associated with traveling are becoming exorbitant.
With that in mind, Dr. Wilcox has agreed to offer a telephone consultation to men who can provide our office with documentation of a physical examination by a physician, PA or nurse practitioner that includes blood pressure, pulse rate, height and weight, HEENT, neck, heart, lung, abdomen and genitourinary exam and especially digital rectal and prostate examination. The prostate exam must be documented as normal (in a patient with a prostate) and the exam must have occurred within 2 months of the scheduled telephone consultation before Dr. Wilcox would be able to prescribe testosterone. In this way, a physical examination from your local health care provider can act as a proxy for the examination he would conduct if you were seen in our office in person.
The other information we would require prior to the consultation would include a blood test panel and the completed health questionnaire. The blood testing can be done at any LabCorp laboratory near your residence, and the questionnaire will be e-mailed or faxed to you for completion upon sign-up and then needs to be returned to our office prior to the consultation. Call our office at 435-688-8582 for details.
Perimenopause and 
